{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ENERILLEB N","gend":1,"add":"      EVIRD SNOSRAP   013                         ","city":"CHARLOTTESVILLE          ","state":"VA","zip":"22901-3224","dob":"1982-02-12","age":"","mstatus":"","insh":"10117887","cliId":"","pno":"2343465627","cno":4342040312,"email":"","ename":"","eno":"","pphy":"WOLF, ANDREW MICHAEL","ppno":4349241212,"pcpadd":"100 COLONNADES HILL DR,","pcpcity":"Charlottesville","pcpstate":"VA","pcpzip":229012204,"pcpcounty":"","pcpid":"","pcpname":"THE COLONNADES HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"APT 201                                           ","add3":"","madd1":"310   PARSONS DRIVE                               ","madd2":"APT 201                                           ","madd3":"","mcity":"CHARLOTTESVILLE          ","mstate":"VA","mzip":"22901-3224","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N18.6","E21.3","D50.9","D63.1","Z99.2","F51.05","I15.0","I50.23","F99","R79.9","N30.00","R10.30","K59.00","N76.0","A59.9","I11.0","I50.9","N18.5","Z79.899","F17.210","Z90.49","B96.89","Z53.21","Z01.818","Z86.79","Z01.810","Z98.890","Z86.73","I10","G47.33","Z87.891","Z86.69","R07.89","R06.02","R00.2","I51.7","I51.89","E78.5","K21.9","J30.9","Z11.59","Z00.00","R05","N25.81","N31.9","N32.81","R35.1","R35.0","Z87.440","N39.0","I12.0","I13.2","I50.20","Z91.15","Z01.812","Z20.822","R30.0","Z88.8","Z88.5","Z45.2","I50.33","I24.8","R11.2","R00.0","R60.1","E87.79","R10.32","I15.1","I45.6","N28.89","T85.691A","T85.71XA","I16.0","R10.9","T80.212A","E88.9","M90.80","K65.9","R06.00","M79.89","J81.1","J90","L08.89","R07.9","E87.70","Y84.8","I50.32","F32.A","J45.909","G40.909","E28.2","N17.9","R18.8","E83.39","G40.109","I16.1","R60.0","I50.43","I21.4","I49.40","R05.9","R79.89","R77.8","G47.09","R05.1"," ","N18.9","I13.0","R53.1","R14.0","J02.9","R05.3","I50.31","E87.20","E21.0"],"date":["2022-11-29","2022-11-01","2022-05-17","2022-11-01","2022-11-29","2022-01-31","2022-01-31","2022-01-31","2022-01-31","2021-05-27","2022-05-20","2021-05-21","2021-05-21","2021-05-21","2021-05-21","2022-05-20","2022-11-29","2021-05-21","2021-05-21","2022-11-29","2022-09-07","2021-05-21","2021-05-27","2022-03-30","2021-08-13","2021-08-13","2021-08-13","2022-09-18","2022-11-01","2021-08-13","2022-11-03","2021-08-13","2022-11-29","2022-11-29","2021-08-13","2022-11-29","2021-08-13","2022-09-09","2021-08-13","2021-08-13","2022-09-22","2022-03-21","2021-09-28","2022-11-22","2021-11-30","2021-11-30","2021-11-30","2022-05-20","2021-11-30","2022-11-22","2022-11-03","2022-11-29","2021-12-10","2022-03-21","2022-04-14","2022-11-29","2022-05-27","2022-10-25","2022-05-20","2022-09-15","2022-11-03","2022-08-30","2022-08-29","2022-09-07","2022-08-29","2022-09-18","2022-09-18","2022-11-22","2022-09-18","2022-11-22","2022-09-15","2022-09-16","2022-11-22","2022-09-17","2022-09-17","2022-09-14","2022-09-14","2022-09-14","2022-09-07","2022-09-13","2022-09-07","2022-11-21","2022-09-14","2022-11-29","2022-11-03","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2022-11-23","2022-08-28","2022-08-28","2022-08-28","2022-08-29","2022-11-29","2022-08-29","2022-08-29","2022-09-09","2022-11-29","2022-10-25","2022-10-25","2022-11-03","2022-10-25","2022-11-29","2022-11-23","2022-11-21","2022-11-29","2022-11-29","2022-11-29","2022-11-21","2022-11-22","2022-11-22","2022-11-01"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68180030360","CEFUROXIME","TAB 500MG","20","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","10","Select","Select",""],["","00832054211","BUMETANIDE","TAB 2MG","360","Select","Select",""],["","00781208102","CALC","CAP 667MG","540","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","90","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","57664049983","MIRTAZAPINE","TAB 15MG","30.00","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","90","Select","Select",""],["","65862019299","FLUOXETINE","CAP 10MG","60","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30.00","Select","Select",""],["","16714071503","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","16714081401","SEVELAMER","TAB 800MG","90","Select","Select",""],["","172572860","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","71930001752","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","00228212810","CLONIDINE","TAB 0.2MG","180","Select","Select",""],["","67877022210","GABAPENTIN","CAP 100MG","270","Select","Select",""],["","43547026810","ROPINIROLE","TAB 0.25MG","90.00","Select","Select",""],["","68382009505","CARVEDILOL","TAB 25MG","180","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","31722053960","LEVETIRACETA","TAB 1000MG","90","Select","Select",""],["","00049350079","DIFLUCAN","TAB 150MG","1","Select","Select",""],["","62756079888","DIVALPROEX","TAB 500MG DR","180","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.5","Select","Select",""],["","68462010910","TOPIRAMATE","TAB 100MG","180","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}